Decline in Public Spending on Biopharmaceutics in Brazil

Abstract Biopharmaceuticals, mainly monoclonal antibodies, and fusion proteins are drugs that have gained notoriety in the treatment of various chronic and inflammatory diseases and have high prices. The study aimed to verify which monoclonal antibodies and fusion proteins were most incorporated into the Unified Health System (SUS), which therapeutic indication most benefited from them and to analyze public spending on these biopharmaceuticals from January 2012 to September 2019. This study performed a qualitative and quantitative analysis of biopharmaceuticals incorporated by SUS. The data were collected on the websites of CONITEC and the Health Price Bank. The results demonstrated that subcutaneous adalimumab was most frequently incorporated, and the most requested therapeutic indication was rheumatoid arthritis. Public spending on biopharmaceuticals exceeded R$ 28 billion (more than US$ 140 billion). However, a downward trend was confirmed (-266.7%) in the period evaluated. Despite the increase in demand and public spending on biologics in general, in Brazil and worldwide, the results of this research show that there was a drop in public spending on the biopharmaceuticals studied in the last seven years.

O perfil das tecnologias em saúde incorporadas no SUS de 2012 a 2019: quem são os principais demandantes? / The profile of health technologies incorporated in SUS during 2012-2019: who are the mainly demanders?

RESUMO As tecnologias em saúde têm revolucionado a assistência médica e a gestão em saúde. A Comissão Nacional de Incorporação de Tecnologias no SUS (Conitec) é o órgão do Ministério da Saúde que assessora na incorporação, exclusão ou alteração de novas tecnologias no Sistema Único de Saúde (SUS). O presente estudo objetivou descrever o perfil das tecnologias incorporadas no SUS de 1 de janeiro de 2012 a 30 de setembro de 2019. Os dados foram coletados no site da Conitec. Na análise estatística, foi utilizado o teste Qui-quadrado de Pearson e o Teste Exato de Fisher. Os resultados demonstram que foram incorporadas 380 tecnologias, prevalecendo os medicamentos (46,6%). Em relação aos demandantes, os de origem interna superaram os demais (82,4%), principalmente secretarias do Ministério da Saúde (p<0,001). As Doenças Infecciosas e Parasitárias (DIPs) foram as mais beneficiadas (20,3%), com destaque para o HIV (Vírus da Imunodeficiência Humana). A maioria das tecnologias incorporadas passou por consulta pública (p<0,001). Conclui-se que o perfil das tecnologias incorporadas são principalmente medicamentos, por demanda interna, com indicação para DIPs e, sobretudo para o HIV. Os medicamentos continuam sendo o foco das solicitações e as demandas internas passaram a ter mais espaço nesse cenário.

ABSTRACT Health technologies have revolutionized medical care and health management. The National Commission for the Incorporation of Technologies in the SUS (Conitec) is the Ministry of Health's body that advises on the incorporation, exclusion or alteration of new technologies in the Unified Health System (SUS). This study aimed to describe the profile of technologies incorporated in the SUS between January 1, 2012 and September 30, 2019. Data were collected on the Conitec website. Statistical analysis used Pearson's chi-square test and Fisher's exact test. The results show that 380 technologies were incorporated, with medication prevailing (46.6%). In relation to the plaintiffs, those of internal origin surpassed the others (82.4%), mainly secretariats of the Ministry of Health (p<0.001). Infectious and Parasitic Diseases (PIDs) were the most benefited (20.3%), with emphasis on HIV (Human Immunodeficiency Virus). Most of the incorporated technologies underwent public consultation (p<0.001). It is concluded that the profile of the incorporated technologies are mainly medicines, by internal demand, with indication for PIDs and, above all, for HIV. Medicines continue to be the focus of requests and internal demands have gained more space in this scenario.